Journal Article

A Randomized Double-Blind Study of Caspofungin versus Amphotericin for the Treatment of Candidal Esophagitis

Alvaro Villanueva, Eduardo G. Arathoon, Eduardo Gotuzzo, Rayanne S. Berman, Mark J. DiNubile and Carole A. Sable

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 9, pages 1529-1535
Published in print November 2001 | ISSN: 1058-4838
Published online November 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/323401
A Randomized Double-Blind Study of Caspofungin versus Amphotericin for the Treatment of Candidal Esophagitis

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Caspofungin is a new broad-spectrum antifungal drug. A multicenter, double-blind, randomized trial was conducted to assess the efficacy, safety, and tolerability of caspofungin relative to amphotericin B in adults with endoscopically documented symptomatic Candida esophagitis. By use of a modified intent-to-treat analysis, endoscopically verified clinical success was achieved in 74% (95% confidence interval [CI], 59%–86%) and 89% (95% CI, 72%–98%) of patients receiving caspofungin at 50 and 70 mg/day, respectively, and in 63% (95% CI, 49%–76%) of patients given amphotericin B at 0.5 mg/kg/day. Therapy was stopped because of drug-related adverse events in 24% of patients in the amphotericin B group and 4% and 7%, respectively, for the caspofungin groups. This report provides the first demonstration of clinical utility for an echinocandin compound. Caspofungin appeared in this study to be as effective as and better tolerated than amphotericin B for the treatment of esophageal candidiasis.

Journal Article.  4371 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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